血栓弹力图评价血小板花生四烯酸途径抑制率对血凝块形成的影响  

Inhibitory effect of arachidonic acid pathway in platelets on clot formation assessed by thromboelastography

作　　者：黎金庆[1] 周合冰[1] 郭金成[2] 单志娟[1] 张娟[1] 曾惠[1] 付晨晓 

机构地区：[1]通州区潞河医院血液科,北京101149 [2]通州区潞河医院心内科,北京101149

出　　处：《军医进修学院学报》2011年第5期430-431,434,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的了解血小板花生四烯酸途径抑制率对血凝块形成的影响及其与ADP受体途径抑制率的关系。方法联用阿司匹林和氯吡格雷的急性冠脉综合征80例,血栓弹力图测定血小板抑制率和花生四烯酸通道的α角、K时间、MA、TMA。结果花生四烯酸途径抑制率为(81.7±20.7)%,ADP受体抑制率为(65.9±25.3)%,α角为(48.2±15.9)°,MA为(20.8±14.2)mm,TMA为(13.8±7.5)min。随花生四烯酸途径抑制率增高,α角缩小,MA降低,TMA缩短,ADP受体抑制率增高(P<0.05),K时间延长并且无K时间病例增多。结论抑制血小板花生四烯酸途径不利于血凝块形成,随抑制率增高,血凝块形成减慢、强度变小;二条途径抑制率呈正相关。Objective To study the inhibitory effect of arachidonic acid pathway in platelets on clot formation and its correlation with ADP receptor inhibition.Methods Eighty patients with acute coronary syndrome were treated with aspirin（100mg） in combination with clopidogrel（75mg） daily.Inhibitory rate of arachidonic acid pathway and ADP receptor pathway in platelets were detected by thromboelastography.The following varibles of arachidonic acid channel were also recorded：αangle,K time,maximum amplitude（MA） and time to MA（TMA）.Results The inhibitory rate of arachidonic acid pathway and ADP receptor pathway was 81.7%±20.7% and 65.9%±25.3%,respectively.The α angle,MA and TMA were（48.2±15.9）°,（20.8±14.2）mm and（13.8±7.5）min,respectively.The α angle became smaller,the MA decreased and the TMA became shorter with the increasing inhibitory rate of arachidonic acid pathway（P0.05）.The number of cases having no K time was increased when the K time became longer.Conclusion Inhibition of arachidonic acid pathway in platelets is not favorable for clot formation.The speed and strength of clot formation decrease with the increasing inhibitory rate of arachidonic acid pathway.The inhibition rates of arachidonic acid pathway and ADP receptor pathway are positively correlated.

关 键 词：血栓弹力描记术 阿司匹林 氯吡格雷 

分 类 号：R973[医药卫生—药品]